Oral Versus Intravenous Hydration to Prevent Contrast Induced Nephropathy (HYDRATE)
Contrast Induced Nephropathy
About this trial
This is an interventional prevention trial for Contrast Induced Nephropathy focused on measuring Contrast induced nephropathy, Percutaneous transluminal coronary angioplasty, chronic kidney disease, Prevention, Equivalence
Eligibility Criteria
Inclusion Criteria:
- Stable serum creatinine levels of at least 1.1 mg/dL or estimated creatinine clearance less than 60 mL/min
- Scheduled for diagnostic, elective cardiac angiography
Exclusion Criteria:
- Serum creatinine levels >8.0 mg/dL
- Change in serum creatinine levels of at least 0.5 mg/dL during the previous 24 hours
- Preexisting dialysis
- Multiple myeloma or other myeloproliferative disease
- Current CHF or recent history of flash pulmonary edema
- Current myocardial infarction
- Symptomatic hypokalemia
- Uncontrolled hypertension (treated systolic blood pressure >200 mmHg or diastolic blood pressure >100mmHg)
- Exposure to radiocontrast within 7 days the study
- Emergency Catheterization
- Allergy to radiographic contrast
- Pregnancy
- Administration of dopamine, mannitol, fenoldapam, or N-acetylcysteine during the time of the study
- Severe COPD
- Serum Bicarb > 28
- Sodium <133
Sites / Locations
- The Western Pennsylvania Hospital
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Active Comparator
Active Comparator
Active Comparator
Active Comparator
Intravenous Hydration
Intravenous hydration and sodium bicarbonate
Oral hydration
Oral hydration and oral sodium bicarbonate
Pretreatment with a 3 mL/kg bolus of intravenous normal saline solution (154 mEq/L) over 1 hour, immediately prior to contrast exposure followed by intravenous infusion of 1ml/kg per for 6 hours after the procedure.
Pretreatment with a 3 mL/kg bolus of intravenous sodium bicarbonate solution (154 mEq/L) over 1 hour, immediately prior to contrast exposure followed by intravenous infusion of 1 mL/kg for 6 hours after the procedure.
Oral hydration with 500 mL of water to be started 4 hours prior to contrast exposure and stopped 2 hours prior to procedure followed by oral hydration with 600 mL of water post procedure
Oral hydration with 500 mL of water to be started 4 hours prior to procedure and stopped 2 hours prior to contrast exposure, with the addition of 3.9 grams (46.4 mEq) of oral sodium bicarbonate to be given 20 minutes prior to contrast exposure followed by 1.95 grams (30.4 mEq) of oral sodium bicarbonate 2 hours and 4 hours after the initial dose